ORIGINAL RESEARCH article
Front. Oncol.
Sec. Thoracic Oncology
Volume 15 - 2025 | doi: 10.3389/fonc.2025.1650373
This article is part of the Research TopicReal-World Data and Real-World Evidence in Lung Cancer Volume IIView all 8 articles
Marked Under-Diagnosis of Lambert-Eaton Myasthenic Syndrome in Small Cell Lung Cancer: An Analysis of Real-World Claims Data
Provisionally accepted
- 1University of Texas Southwestern Medical Center, Dallas, United States
- 2Catalyst Pharmaceuticals Inc, Coral Gables, United States
- 3Northeast Epi, LLC, Bradford, New Hampshire, United States
- 4MedTech Analytics, LLC, , USA, Lexington, Massachusetts, United States
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Background: Lambert-Eaton myasthenic syndrome (LEMS) is an autoimmune neurologic condition causing progressive muscle weakness that can occur as a paraneoplastic disorder, most commonly in patients with small cell lung cancer (SCLC). In limited prospective and retrospective studies, LEMS incidence in SCLC populations ranges 3-6%. Because LEMS may present a diagnostic challenge, we determined the prevalence of LEMS in a large, real-world, U.S.-based SCLC cohort. Materials and Methods: We conducted a retrospective analysis of administrative data from Symphony Health's PatientSource®, which represents over 300 million U.S. patients. In the primary analysis, we identified claims for LEMS (available starting in 2014) among patients with lung cancer claims between 2017 and 2022 who received etoposide and platinum-based chemotherapy (a validated approach to SCLC case identification). Results: Among 867,170 patients with lung cancer claims, 46,995 (5.4%) received platinum-etoposide-based therapy (putative SCLC cohort), of whom 77 (0.16%) had LEMS claims. In a subset of 8,513 patients with ≥12 months of claims preceding and following lung cancer diagnosis, 16 (0.19%) had LEMS claims. LEMS cases were more frequently diagnosed by neurologists (30%) than by oncologists (13%). Conclusions: In a large real-world cohort of patients with lung cancer, LEMS is diagnosed far less frequently than would be expected and rarely by oncologists. Because LEMS may convey substantial morbidity and specific LEMS treatments are available, further efforts to understand and address this discrepancy are warranted.
Keywords: Autoimmune, claims data, Lambert-Earon Myasthenic Syndrome (LEMS), Neurology, oncology, Paraneoplastic, Real-world, Small cell lung cancer (SCLC)
Received: 19 Jun 2025; Accepted: 29 Sep 2025.
Copyright: © 2025 Drapkin, Morrell, Grebla, Shechter and Gerber. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: David Gerber, david.gerber@utsouthwestern.edu
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